A recently published study explored the effect of tobacco retailer density, neighborhood poverty, and housing type (multiunit and public) on smoking in a large urban environment (New York City). Researchers analyzed data on smoking prevalence and individual sociodemographic characteristics from the 2011-2013 New York City Community Health Survey, data on tobacco retailers from the 2012 New York City Department of Consumer Affairs, data on neighborhood sociodemographic characteristics and population density from the 2009-2013 American Community Survey, and data on multiunit and public housing from the 2012 New York City Primary Land Use Tax Lot Output data set.
- Neighborhood poverty positively and significantly modified the association between tobacco retailer density and prevalence of neighborhood smoking.
- Neighborhood poverty was positively associated with the prevalence of individual smoking.
Source: Farley et al. (2019). The Influence of Tobacco Retailer Density and Poverty on Tobacco Use in a Densely Populated Urban Environment. Public Health Reports, Mar/Apr;134(2):164-171. doi: 10.1177/0033354918824330. Epub 2019 Feb 14.
A newly published study examined changes in prevalence of e-cigarette use and perceptions of the harmfulness of e-cigarette and combustible cigarettes following a campus-wide tobacco ban. Undergraduate students completed surveys of tobacco use and perceived product harmfulness. Four samples were collected: in 2013 prior to the ban (n = 792) and in fall 2014 (n = 310), 2015 (n = 208), and 2016 (n = 417).
- E-cigarette use increased in the years following the ban while combustible cigarette use decreased from 2013 to 2016.
- Men were more likely than women to use both products.
- Students’ perceptions of the harmfulness of combustible and electronic cigarettes remained stable in the years following the ban.
Source: Leavens et al. (2019). Electronic cigarette and combustible cigarette use following a campus-wide ban: Prevalence of use and harm perceptions. Journal of American College Health, Jan 25:1-4. doi: 10.1080/07448481.2018.1551803. [Epub ahead of print]
A recently published study examined the burden of tobacco and substance use disorders among hospitalized heart failure patients in the United States.
- Of 989,080 heart failure hospitalizations, 16% had documented tobacco or substance use disorder.
- Female sex was associated with lower rates of tobacco and substance use disorder.
- Tobacco and substance use disorder rates were highest for hospitalizations <55 years of age.
- Medicaid insurance or income in the lowest quartile were associated with increased risk of tobacco and substance use disorders.
The researchers concluded that enhanced screening for tobacco and substance use disorders in hospitalized heart failure patients may reveal opportunities for treatment and secondary prevention.
Source: Snow et al. (2018). National Rate of Tobacco and Substance Use Disorders Among Hospitalized Heart Failure Patients. The American Journal of Medicine, Dec 16. pii: S0002-9343(18)31168-9. doi: 10.1016/j.amjmed.2018.11.038. [Epub ahead of print]
Few studies have focused on understanding how sociodemographic factors impact healthy ageing in the rapidly growing population of Alaskan older adults. A newly published study compared the health of Alaskan older adults to those in the contiguous US, and determined how the associations differ between older adults in Alaska and the contiguous US.
· In the contiguous US, females were less likely than males to be obese, while in Alaska, females were more likely to be obese.
· In the contiguous US, Alaska Natives/American Indians were more likely than respondents of other races to be smokers, while in Alaska, the association between race and smoking was not significant.
· These differences between Alaska and the contiguous US results suggest that programs designed to reduce disparities and promote healthy behaviours may need to be tailored to meet the unique needs and challenges of older adults living in Alaska.
Source: Cohen et al. (2019). Disparities in social determinants of health outcomes and behaviours between older adults in Alaska and the contiguous US: evidence from a national survey. International Journal of Circumpolar Health, Dec;78(1):1557980. doi: 10.1080/22423982.2018.1557980.
Restricting youth access to tobacco is a central feature of US tobacco regulatory policy, but impact of local tobacco retail licensing (TRL) regulation on cigarette smoking rates remains uncertain. A newly published study examined the effects of TRL on other tobacco product use and use as adolescents reach the age to legally purchase tobacco products. Prevalences of ever and past 30-day cigarette, electronic cigarette (e-cigarette), cigar, and hookah use were assessed in a survey of a cohort of 1553 11th- and 12th-grade adolescents. An American Lung Association (2014) youth access grade was assigned to each of 14 political jurisdictions in which participants lived on the basis of the strength of the local TRL ordinance.
· At baseline, participants living in 4 jurisdictions with “A” grades (ie, with most restrictive ordinances) had lower odds of ever cigarette use and past 30-day use than participants in 10 D- to F-grade jurisdictions.
· At follow-up at legal age of purchase, lower odds of cigarette use initiation occurred in jurisdictions with stronger TRL policy.
· Lower odds of e-cigarette initiation at follow-up and of initiation with past 30-day use were also associated with better regulation.
The researchers concluded that strong local TRL ordinance may lower rates of cigarette and e-cigarette use among youth and young adults.
Source: Astor et al. (2019). Tobacco Retail Licensing and Youth Product Use. Pediatrics, Jan 7. pii: e20173536. doi: 10.1542/peds.2017-3536. [Epub ahead of print]
Abstract Smoke Background
Tobacco use is highly prevalent among individuals with posttraumatic stress disorder (PTSD), depressive disorders, and pain. A recently published study examined the clustering of current PTSD, depressive disorders, and clinically significant pain according to current tobacco use and dependence among post-9/11 deployed veterans. The study found that moderate to high dependence on tobacco was associated with substantially increased clustering of PTSD, depression, and clinically significant pain in veterans. The researchers concluded that research examining synergistic interactions among these conditions, biological vulnerabilities shared among them, and the direct impact of tobacco use on the pathophysiology of PTSD, depression, and pain is needed. The results of such work may spur development of more effective integrated treatments to reduce the negative impact of these multi-morbid conditions on veterans’ wellbeing and long-term health.
Source: Fonda et al. (2019). Tobacco dependence is associated with increased risk for multi-morbid clustering of posttraumatic stress disorder, depressive disorder, and pain among post-9/11 deployed veterans. Psychopharmacology, Jan 7. doi: 10.1007/s00213-018-5155-6. [Epub ahead of print]
Certain racial and ethnic minorities have lower utilization of tobacco cessation services, such as Helpline counseling and cessation medications. The goal of the California Medicaid (Medi-Cal) Incentives to Quit Smoking Program was to facilitate successful cessation by promoting modest financial and cessation medication-related incentives to increase engagement with the California Smokers’ Helpline counseling services. A newly published study examined differences in the response to incentives and outreach on engagement with Helpline services among racial/ethnic groups within the Medi-Cal population.
- African Americans and English-speaking Hispanics/Latinos had higher engagement with the financial incentive ($20) compared to whites.
- Spanish-speaking Hispanics/Latinos had lower initial engagement with the financial incentive but higher engagement with Medi-Cal’s all-household mailing.
- Although African Americans and English-speaking Hispanics/Latinos had similar rates of completing counseling and receiving nicotine replacement therapy as whites, Spanish-speaking Hispanics/Latinos had higher rates compared to whites.
The researchers concluded that the promotion of modest financial and cessation medication incentives through multiple outreach channels increased callers’ engagement with the Helpline and appeared to promote ethnic and linguistic equity with respect to the receipt of counseling and nicotine replacement therapy. Targeted community-based outreach may resonate particularly for African Americans, and language-concordant Medi-Cal insurance plan mailings may have reached newly covered Spanish-speaking Hispanics/Latinos.
Source: Vijayaraghavan et al. (2018). Racial/Ethnic Differences in the Response to Incentives for Quitline Engagement. American Journal of Preventive Medicine, Dec;55(6S2):S186-S195. doi: 10.1016/j.amepre.2018.07.018.
Persons in addiction treatment have among the highest smoking prevalence of any population. A recently published study examined racial and ethnic disparities in tobacco use prevalence, behaviors, and services among persons in addiction treatment.
- There was no difference in cigarette smoking prevalence across racial/ethnic groups.
- Hispanics and African Americans, compared to Whites, were less likely to be daily smokers, use smokeless tobacco, or use e-cigarettes.
- African Americans and Hispanics reported more past-year quit attempts and higher use of menthol compared to Whites.
- Hispanics were more interested in quitting while in treatment than Whites.
- African Americans reported receiving more tobacco cessation advice and services while in treatment than Whites.
The researchers concluded that the findings indicate the need for continued engagement of African Americans and Hispanics in cessation services while in addiction treatment, and for addressing heavier tobacco use and lack of interest in cessation during treatment among White clients.
Source: Pagano et al. (2018). Differences in tobacco use prevalence, behaviors, and cessation services by race/ethnicity: A survey of persons in addiction treatment. Journal of Substance Abuse Treatment, Nov; 94:9-17. doi: 10.1016/j.jsat.2018.08.003. Epub 2018 Aug 8.
A newly published study whether self-reported and geographically estimated tobacco retailer exposures differ by participant or neighborhood characteristics among urban and rural adolescents. The data for this study were part of a cohort study of 1220 adolescent males residing in urban and rural (Appalachian) regions in Ohio. The baseline survey asked participants how often they visited stores that typically sell tobacco in the past week (self-reported exposures). The number of tobacco retailers between home and school was determined using ArcGIS software (potential exposures).
· Adolescents who were non-Hispanic black or other racial/ethnic minority, had used tobacco in the past, and lived in rural areas had higher self-reported exposures.
· Urban adolescents, non-Hispanic black or other racial/ethnic minority, and those living in neighborhoods with a higher percentage of poverty had more potential exposures to tobacco retailers in their path between home and school.
The researchers concluded that rural adolescents had more self-reported marketing exposures than urban adolescents. However, urban adolescents had more potential tobacco exposures between home and school. Thus, point of sale marketing limitations might be a more effective policy intervention in rural areas whereas limits on tobacco retailers might be more effective for urban areas.
Source: Burgoon et al. (2019). Exposures to the tobacco retail environment among adolescent boys in urban and rural environments. American Journal of Drug and Alcohol Abuse, Jan 2:1-10. doi: 10.1080/00952990.2018.1549562. [Epub ahead of print]
It is unclear whether health risk behaviors differ by nuanced marital statuses and race/ethnicity. A recently published study examined the association between detailed marital status and current cigarette smoking among U.S. adults by race/ethnicity. Data were from four Health Information National Trends (HINTS) study cycles collected in 2011-2017 with a nationally representative sample of adults 30 years and older (n = 11,889).
· Adults who had the highest prevalence of cigarette smoking were non-Hispanic Black cohabiters (36%), separated non-Hispanic White adults (35%), and single/never married Hispanic adults (28%).
· Widowed adults had lower cigarette smoking prevalence than those who were divorced or separated across races/ethnicities.
Source: Ramsey et al. (2019). Association between marital status and cigarette smoking: Variation by race and ethnicity. Preventive Medicine, Feb;119:48-51. doi: 10.1016/j.ypmed.2018.12.010. Epub 2018 Dec 18.